Medical technologies are now expanding so that curative therapies may now be applied directly to the wall of a vascular structure or other body lumen (e.g., tubular structure or organ) within the human body. In most situations it will be necessary to access the inside (or other portion) of the wall of a vascular structure or other body lumen in order to provide therapy to a patient. By way of example but not limitation, it may be necessary to treat an aneurysm formed in the wall of an artery (e.g., a lateral aneurysm such as a saccular aneurysm, a fusiform aneurysm such as a typical abdominal aortic aneurysm), or to treat a lesion formed on the wall of a vascular structure (e.g., an artery or vein) or other tubular or hollow structure. As used herein, the term “vascular structure” is intended to encompass any tubular or hollow structure of the vasculature (e.g., an artery, a vein, a blood chamber, etc.), and the term “body lumen” is intended to encompass any tubular or hollow structure, including the gastrointestinal or genitourinary tracts, the lymph system, an air passageway, the interior of a hollow organ, a passageway through a body structure, etc. As used herein, the term “wall” of a vascular structure or other body lumen is intended to encompass the inside surface of the wall and/or any other portion of the wall, including aneurysms, lesions, etc. which may be formed in or on the wall.
Additionally, in many situations it may be desirable to isolate a segment of the vascular structure (or other body lumen) from the remainder of the vascular structure (or other body lumen). By way of example but not limitation, a particular therapy applied to the inside of the wall of a vascular structure may create debris which should be localized and prevented from flowing downstream from the site of the therapy.
Furthermore, in many situations it may become necessary to apply therapy to the inside of the wall of a vascular structure (or other body lumen) without interrupting the flow of blood (or other fluids) through the vascular structure (or other body lumen).
Thus, there is a substantial need for a novel method and apparatus for accessing the wall of a vascular structure or other body lumen while simultaneously providing “zone isolation” and simultaneously providing fluid bypass capability. Ideally, pressure and fluid (presence or absence) should be controllable within the isolation zone, thereby facilitating the use of medical instruments (including cutting instruments, biopsy instruments, closure instruments, endoscopic visualization, etc.), vacuum, electrical energy (e.g., electrosurgery), adhesives and/or other therapies which may be difficult to apply in a zone where blood or any other biologic fluid or substance is present and/or flowing.